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Disease Course Patterns Studied in Patients with SLE

Lupus; ePub 2018 Dec 8; Tselios, Gladman, et al

Approximately 70% of patients with systemic lupus erythematosus (SLE) followed a relapsing-remitting course, whereas 10% displayed prolonged remission and another 10%, a persistently active course, according to a recent study. Early response to treatment, however, was associated with a less severe course and better prognosis. The inception cohort of a lupus clinic (≥10 years follow-up, between visit interval ≤18 months) was investigated. Prolonged remission was defined as a clinical Systemic Lupus Erythematosus Disease Activity Index 2000 = 0 achieved within 5 years of enrollment and maintained for ≥10 years. The relapsing-remitting pattern was defined based on ≥2 remission periods (clinical Systemic Lupus Erythematosus Disease Activity Index 2000 = 0 for 2 consecutive visits). Patients with no remission were categorized as persistently active. Researchers found:

  • Of 267 patients, 27 (10.1%) achieved prolonged remission, 180 (67.4%) relapsing-remitting, and 25 (9.4%) persistently active.
  • In total, 35 (13.1%) had only 1 remission period (hybrid).
  • At enrollment, there were no differences regarding clinical and immunological variables.
  • At 10 years, persistently active patients had accumulated significantly more damage than the prolonged remission and relapsing-remitting patients.

Tselios K, Gladman DD, Touma Z, Su J, Anderson N, Urowitz MB. Disease course patterns in systemic lupus erythematosus. [Published online ahead of print December 8, 2018]. Lupus. doi:10.1177%2F0961203318817132.